Two dimensional echocardiographic detection and measurement of the right pulmonary artery in pulmonary atresia-ventricular septal defect: Angiographic and surgical correlation

Abstract

This study assessed the value of two dimensional echocardiography in patients with pulmonary atresia-ventricular septal defect in order to detect the presence of true pulmonary arteries, measure the dimension of the visible proximal right pulmonary artery and correlate these echocardiographic observations with angiographic and surgical findings. The data from 65 patients (age range 16 months to 54 years) with pulmonary atresia-ventricular septal defect who had both two dimensional echocardiographic and angiographic evaluation to determine the presence of pulmonary arteries were reviewed. Echocardiography allowed visualization of a right pulmonary artery in 55 (85 percent) of the 65 patients. Echocardiography detected a measurable proximal right pulmonary artery in 52 (98 percent) of 53 patients who had confluent pulmonary arteries confirmed with angiography. In three patients without confluence, a large systemic to pulmonary collateral artery was misinterpreted as the right pulmonary artery on two dimensional echocardiography. Right pulmonary arterial measurements on echocardiography (range 3 to 21 mm) showed excellent correlation with angiographic (r = 0.95) and surgical (r = 0.84) measurements. These data indicate that two dimensional echocardiography can be used to visualize proximal true pulmonary arteries (specifically, a right pulmonary artery) in a large proportion of patients with pulmonary atresia-ventricular septal defect; this finding usually denotes the presence of confluent pulmonary arteries. The data also suggest that this method can be reliably used for serial follow-up studies with noninvasive measurement of proximal right pulmonary arterial growth.